Here's to Pickles and Ice Cream

Constant Cravings

WebMD Feature

Reviewed By Charlotte Grayson

Jan. 7, 2002 -- You've heard of the doting husband who runs out at midnight to buy pickles and ice cream for his pregnant wife, who simply couldn't get to sleep without her fix. Legend, you might say? No way. These great guys -- oh yes, andpregnancy cravings -- really do exist.

Bob Gaviglio satisfied his wife Jean's yen for doughnuts -- chocolate honey-dipped, thank you very much -- whenever the mood seized her, with a run to Dunkin' Donuts. And not just during one pregnancy, says Jean, but all three.

"I felt that given the two options -- running around doing things like this or carrying this load in my stomach -- I had by far the better deal, so I was more than willing to do that type of stuff," says Bob, senior relationship manager at the Bank of Nova Scotia in New York.

Lots of women admit to weird cravings and aversions during pregnancy. In most cases, they're nothing to worry about. You should enjoy the new taste sensations you're experiencing as a mom-to-be. Just don't let them replace a healthy diet for the next nine months.

Enjoy the Ride, but Only Around the Block

Food cravings and aversions during pregnancy haven't been explored with any great scientific rigor, so no one knows for sure just how widespread they are, whether certain foods are more common than others, or even why the phenomenon occurs. And it's hard to know just how much of it is psychological.

"If a woman has been raised to believe that during pregnancy one craves pickles, then ... she's likely to crave pickles," says Roy Pitkin, MD, professor emeritus of obstetrics and gynecology at UCLA, and editor of the Journal of Obstetrics and Gynecology.

Doctors and nutritionists do say a woman's senses are often heightened during pregnancy, however, causing certain foods to smell and taste a whole lot better, or a whole lot worse -- triggering the nausea associated with morning sickness.

"There are definitely comfort foods," says Elizabeth Ward, a registered dietician in Boston and author of Pregnancy Nutrition: Good Health for You and Your Baby. "Once you start eating something and realize you like it or that it feels good, then you think again about having it."

Cravings are most likely associated with changes in hormones during pregnancy, says Jennifer Niebyl, MD, head of obstetrics and gynecology at the University of Iowa College of Medicine. Studies have shown that women get food cravings, or appetite changes, when they're taking the hormone progesterone for birth control or to relieve symptoms of menopause.

Should moms-to-be give in to their dietary urges? Pregnancy is supposed to be enjoyable, so have a little fun with your cravings, the experts say, but don't go overboard. The key is making sure you're getting a healthy diet first, and then working in those extras.

"If you eat whatever tastes good, pretty soon you could be 400 pounds," says Bruce Bagley, MD, a family-practice physician in Latham, N.Y. "Make sure you have a balanced diet, and then if you feel like eating ice cream, go ahead, but within a reasonable calorie range."

Women should consume only about 300 more calories than usual per day during pregnancy. That should include one extra serving of milk or dairy for calcium and about 10 additional grams of protein. Fats should remain at 30% or less of total calories.

A more serious condition related to cravings is "pica" -- an urge to eat non-nutritive substances like dirt, chalk, clay, or even toilet paper and laundry starch. There's evidence of these bizarre cravings as far back as ancient civilizations, when people used such substances to quell morning sickness.

"Most of those substances aren't harmful per se, as long as the patient is eating, too. Nutrition is the issue," says. Ronald Chez, MD, professor of obstetrics and gynecology at the University of South Florida. Women are often reluctant to confess such cravings, but discussing them with a doctor or midwife can help assess any nutritional problems.

Chocolates, Blueberries, and Those Pesky 'Momisms'

Is there any rhyme or reason to what you'll reach for? Ward says fatty, sugary, or salty foods are the most common -- hence the pickles and ice cream. Particularly in the first trimester, they may be the only foods you can keep down, and since morning sickness is worse on an empty stomach, cravings may be a protective device to stay full.

But that doesn't mean cravings are your body's way of screaming for foods it needs, experts say. That may be an eye-opener for those of us raised by mothers who took every opportunity to point out that our bodies must be deficient in a food we're craving -- proof that we're not eating right, or enough.

Niebyl says an example commonly used to disprove that old wives' tale is the urge to eat ice cubes, which is often associated with anemia. "That doesn't help the iron deficiency. They need to be eating iron-containing foods." One exception to the rule, however, may be salty foods. The body needs a little more sodium [salt] to balance the extra fluid volume during pregnancy, although the normal diet usually includes enough, adds Ward.

There's also no scientific evidence that what you crave during pregnancy will become one of your child's favorites. Anne Pike, a mother of four who lives in Evanston, Ill., says she ate tons of blueberries during her first pregnancy, and sure enough, by the time David was 1, he already showed an affinity for them. "He loved them as a baby, couldn't get enough of them," she says. With her second, she craved hot dogs, and her daughter, Sara, loves those.

But it's hard to tell whether those would be foods the children would like anyway, or if it's really a matter of conditioning. "There's an element of a self-fulfilling prophecy here," Pitkin says. "Let's say a woman eats chocolate during pregnancy. If she likes it, she's going to have it around the house afterward, too."

And while studies have shown that a fetus does develop a sense of taste in the womb and will even swallow more when the amniotic fluid is sweetened, it's doubtful that the fetus can actually taste what you taste. The food you eat is already metabolized by the time it gets through the umbilical cord to the baby, he says.

The sole evidence for a link between eating habits during pregnancy and children's food preferences is new research indicating that women with morning sickness tend to have children who crave salt as adults. Researchers speculate that it may have to do with dehydration that can occur when pregnant moms are too nauseous to drink enough.

Aversions: The Body's Natural Defense?

Once you're pregnant, certain foods you'd loved can soon become the pits. Carla Laszlo, of Southwick, Mass., says chocolate and sweets used to be staples. "Dessert always came first, and then dinner, if I had room!" Yet after she got pregnant, her yen for sweets disappeared. "I believe our bodies have a natural way of balancing themselves," she says.

The theory that pregnant women will naturally avoid foods that aren't good for them isn't so far-fetched. Margie Profet, an evolutionary biologist and mathematician, published research touting that concept two years ago in the book Pregnancy Sickness: Using Your Body's Natural Defenses to Protect Your Baby-to-Be.

Profet says plants produce an array of natural toxins to deter enemies, so the pungent or bitter tastes and smells of certain foods that trigger morning sickness are nature's way of protecting the embryo, especially during the all-important first trimester when organs form. She recommends a varied diet and says it's best to avoid some of the main culprits, including broccoli, bell peppers, brussels sprouts, onions, garlic, mushrooms, mustard, coffee, and tea. Meats may also contain bacterial toxins, she says.

Cassandra Henderson, MD, associate professor of obstetrics and gynecology at Montefiore Medical Center in New York, says the concept makes sense. She sees plenty of women in her practice who smoke, or drink alcohol or coffee, yet once they get pregnant -- even before they're aware of it -- those substances make them sick.

Yet other studies have neither confirmed nor disproved the theory, and most of the medical community doesn't put much stock in it. The furthest they'll go is to say that aversions and morning sickness are often set off by the smell or taste of certain substances, such as greasy or spicy foods, or cigarette smoke, but they can't explain why.

They also worry that if women give in to aversions without some thought about their overall nutritional intake, they may unwittingly be shortchanging themselves on important nutrients. Many vegetables, for example, contain folic acid and iron, which are important during pregnancy.

"One important, although unusual, aversion is milk," says Pitkin. "Rather than being an aversion, it might actually be a lactose intolerance, and if that's the case, then [we'd] recommend lactose-free milk ... since calcium is important during pregnancy."

"Eating is one of life's more pleasant things," Pitkin says. "It isn't medicine or a treatment. If you want it, have it, as long as your diet provides for that sort of thing. And if you can get your husband to do something he might not otherwise do -- like those midnight grocery store runs -- then sure, go ahead!"